title: Osseous metaplasia of the cervix and endometrium: a case of secondary infertility.
abstract: OBJECTIVE
  To report a case of osseous metaplasia of the cervix and endometrium as a cause of secondary infertility.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Istanbul Bakirkoy Women and Children Teaching and Research Hospital.
  
  
  METHODS
  A 31-year-old patient with secondary infertility owing to osseous metaplasia of the endometrium and cervix in whom uterine perforation occurred during the removal of bone fragments.
  
  
  METHODS
  Diagnostic and operative hysteroscopy and laparotomy.
  
  
  METHODS
  Visualization of the disappearance of the osseous metaplasia region with transvaginal ultrasound examination after the hysteroscopy intervention.
  
  
  RESULTS
  Osseous metaplasia lesions are removed by operative hysteroscopy. During this operation, laparotomy was done because of perforation of the uterine wall, and the perforated area was repaired. Two weeks after surgery, the patient underwent a transvaginal ultrasound examination, and the abnormal ultrasound appearance had resolved.
  
  
  CONCLUSIONS
  As a rare cause of infertility, osseous metaplasia can be seen in the cervix and the endometrium. If osseous metaplasia is deep enough during operative hysteroscopy, uterine perforation may occur. Clinicians must be careful for this reason, especially in cases of deep osseous metaplasia.
authors.affiliation: Infertility Unit, Department of Obstetrics and Gynecology, Istanbul Bakirkoy Women and Children Hospital, Istanbul, Turkey. dripolat@yahoo.com
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Polat
authors.forename: Orhan
authors.initials: O
authors.lastname: Sahin
authors.forename: Gonca
authors.initials: G
authors.lastname: Yildirim
authors.forename: Erbil
authors.initials: E
authors.lastname: Karaman
authors.forename: Adnan
authors.initials: A
authors.lastname: Erim
authors.forename: Ali Ismet
authors.initials: AI
authors.lastname: Tekirdag
mesh_terms: D000328:Adult; D001706:Biopsy; D004717:Endometrium / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000009:adverse effects; D007247:Infertility, Female / Q000175:diagnosis / Q000209:etiology*; D008679:Metaplasia; D009999:Ossification, Heterotopic / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D016896:Treatment Outcome; D014463:Ultrasonography; D002577:Uterine Cervical Diseases / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D014595:Uterine Perforation / Q000209:etiology / Q000601:surgery